Content Solutions Analyst I

Cotiviti

. Research new medical policies and perform quality assurance and opportunity analysis .

Posted 10/21/2026full-timeRemote • United StatesMid-LevelSenior💰 $96,000 - $116,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in clinical coding, payment policy management, and data analysis, with a strong foundation in healthcare regulations and coding standards. Proficient in collaborating with cross-functional teams to develop and enhance payment policies and solutions.

Highest-signal resume keywords

Clinical Coding ExpertisePayment Policy ManagementData Analysis and SynthesisRule Development and Requirement GatheringHealthcare Certifications (RHIA, RHIT, CPC)

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical CodingCPT CodingHCPCS CodingICD CodingNDC CodingData AnalysisRule DevelopmentQuality AssuranceBusiness Logic WritingPayment Integrity

Soft Skills

Analytical SkillsCritical ThinkingProblem-SolvingInterpersonal CommunicationVerbal CommunicationWritten Communication

Tools & Technologies

Microsoft Office Suite

Certifications & Qualifications

RHIARHITCPCCPC-HCCS-PSAFeCPhT

Industry Keywords

Medical PoliciesPayment Policy LibraryOutpatient Payment ManagementInpatient Payment ManagementPharmacy Claims EditingFraud PreventionBehavioral HealthLaboratory Payment Integrity

Tech Stack

Tools & technologies

About the role

Key responsibilities & impact

Research new medical policies and perform quality assurance and opportunity analysis
Review and analyze current medical policies
Research and define logic and algorithms to expand Cotiviti’s payment policy library
Support outpatient, inpatient, pharmacy, fraud, and dental payment policy management solutions
Analyze complex data and synthesize findings for customers and internal teams
Provide coding, claims processing, and industry expertise for clinical coding and pharmacy claims editing policies
Write business logic for new rules and enhancements by translating industry references into Cotiviti policy
Provide input to rule engine developers and system architects on new or complex enhancements
Guide and advise TPOs/developers during ART grooming sessions
Collaborate with Product and Go to Market teams on new policy rollouts
Communicate the content solutions roadmap to internal Cotiviti operational teams
Perform multifaceted analytics for data and report analysis with minimal direction

Requirements

What you’ll need

BS in Nursing; Pharmacist (BSPharm or PharmD); off-shore Medical or Pharmacy degree (MBBS or higher); or other Bachelor’s degree (or equivalent work experience)
RHIA, RHIT, CPC, CPC-H, CCS-P, SAFe, or CPhT certification, or willingness to obtain certification within one year of employment
3 years in a clinical/retail setting as a nurse, pharmacist, or physician, or 3 years of clinical coding in a payer setting
An additional 3 years of research experience related to coding (CPT, HCPCS, ICD, NDC), or at least 3 years in an internal Cotiviti role
5 years of experience in detailed rule requirement gathering, rule development, and collaborating on software enhancements
Experience supporting Behavioral Health and/or Laboratory payment integrity rule development is preferred
Strong analytical, critical thinking, and problem-solving skills
Proficiency in Microsoft Office Suite
Excellent interpersonal, verbal, and written communication skills
Flexibility and willingness to participate in the work processes of an international organization
After-hours and/or weekend work when necessary for major deliverables/deadlines
Ability to provide a dedicated, secure work area
High-speed internet access/connectivity and office setup and maintenance
Ability to remain stationary, often standing or sitting for prolonged periods
Ability to perform repetitive motions involving wrists, hands, and/or fingers

Benefits

Comp & perks

Medical insurance
Dental insurance
Vision insurance
Disability insurance
Life insurance coverage
401(k) savings plan
Paid family leave
9 paid holidays per year
17–27 days of Paid Time Off (PTO) per year, depending on specific level and length of service
Remote work arrangement
Dedicated secure work area and high-speed internet/office setup support required